Temporal Changes in Health Care Utilization among Participants of a Medically Supervised Weight Management Program.

ABSTRACT

CONTEXT Obesity is associated with increased incidence of chronic diseases such as type 2 diabetes mellitus, systemic hypertension, and other risk factors for cardiovascular disease. Obesity is also associated with increased use of outpatient clinical services, a metric of health care utilization. However, little is known of temporal changes in health care utilization among obese participants of a medical weight management program. OBJECTIVE: To assess changes in 3 health care utilization metrics (primary care physician office visits, ambulatory clinic office visits, and health care touches [encounters]) in weight management program participants across 21 Kaiser Permanente Northern California Medical Centers during a 5-year period. DESIGN: Retrospective observational study of 10,693 participants, with a linear-mixed effects model to account for repeated-measures analysis. MAIN OUTCOME MEASURES: Five-year temporal changes in the 3 health care metrics. RESULTS: At baseline, the participants' average age (standard deviation) was 51.1 (12.4) years, and their mean body mass index (standard deviation) was 39.7 (7.2) kg/m2. At the end of 4 months, there was a decrease in primary care visits (p < 0.001), with an increase in ambulatory clinic visits and health care touches (p < 0.001), because of increased weight management visits. At the end of 5 years, there was a 25% to 35% decrease from baseline in all 3 health care utilization metrics (p < 0.0001). Although slightly attenuated, these findings were similar in a risk-adjusted model. CONCLUSION: Our findings may be useful to other integrated health care delivery systems considering initiating a similar weight management program.